The Pathogenesis of Tourette Syndrome

A Review of Data and Hypotheses
  • James F. Leckman
  • Donald J. Cohen
  • R. Arlen Price
  • Mark A. Riddle
  • Ruud B. Minderaa
  • George M. Anderson
  • David L. Pauls


Tourette syndrome (TS) is a rare, chronic neuropsychiatric disorder of unknown etiology that is characterized by waxing and waning multiform motor and phonic tics and a broad range of behavioral symptoms (Shapiro et al.,1978; Cohen et al.,1982; Leckman et al.,1983a).


Tourette Syndrome Stimulant Medication Amphetamine Administration Tourette Syndrome Patient Intermittent Electrical Stimulation 
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  1. Adamec, R. E., and Stark-Adamec, C., 1983, Limbic kindling and animal behavior—Implications for human psychopathology associated with complex partial seizures, Biol. Psychiatr. 18: 269–293.Google Scholar
  2. Akiyama, K., Sato, M., and Otsuki, S., 1982, Increased 3H-spiperone binding sites in mesolimbic area related to methamphetamine-induced behavioral hypersensitivity, Biol. Psychiatr. 17 (2): 223–231.Google Scholar
  3. Anden, N. E. Corrodi, H., Fuxe, K., Hokfelt, B., Hokfelt, T., Rydin, C., and Svensson, T., 1970, Evidence for a central noradrenaline receptor stimulation by clonidine, Life Sci. 9: 513–523.PubMedCrossRefGoogle Scholar
  4. Anderson, G. M., Shaywitz, B. A., Riddle, M. A., Hoder, E. L., Lu, X., and Cohen, D. J., 1983, CSF monoamine metabolite and precursor measurements in the rat pup and children, Pediatr. Res. 17: 126A.CrossRefGoogle Scholar
  5. Angrist, B. M., and Gershon, S., 1970, The phenomenology of experimentally induced amaphetamine psychosis: Preliminary observations, Biol. Psychiatr. 2: 95–107.Google Scholar
  6. Anisman, H., 1978, Neurochemical changes elicited by stress, in: Psychopharmacology of Aversively Motivated Behaviors ( H. Anisman and G. Bignami, eds.), pp. 119–161, Raven Press, New York.Google Scholar
  7. Antelman, S. M., Eichler, A. J., Black, C. A., and Kocan, D., 1980, Interchangeability of stress and amphetamine in sensitization, Science 207: 329–331.PubMedCrossRefGoogle Scholar
  8. Bachman, D. S,. 1981, Pemoline-induced Tourette’s disorder: A case report, Am. J. Psychiatry 138: 1116–1117.PubMedGoogle Scholar
  9. Borison, R. L., Ang, L., Chang, S., Dysken, M., Comaty, J. E., and Davis, J. M, 1982, New pharmacological approaches in the treatment of Tourette syndrome, in: Gilles de la Tourette Syndrome, Advances in Neurology, Vol. 35 (A. J. Friedhoff and T. N. Chase, eds.), pp. 377–382, Raven Press, New York.Google Scholar
  10. Braestrup, C., and Nielsen, M., 1976, Regulation in the use of central norepinephrine neurotransmission induced in vivo by alpha adrenoceptor active drugs, J. Pharmacol. Exp. Ther. 198: 596–608.PubMedGoogle Scholar
  11. Bunney, B. S., and DeRiemer, S., 1982, Effects of clonidine on dopamine neuron activity in the substantia nigra: Possible indirect mediation by noradrenergic regulation of the serotonergic raphe system, in: Gilles de la Tourette Syndrome, Advances in Neurology, Vol. 35 ( A. J. Friedhoff and T. N. Chase, eds.), pp. 99–104, Raven Press, New York.Google Scholar
  12. Butler, I. J., Koslow, S. H., Seifert, W. E., Jr., Caprioli, R. M., and Singer, H. S., 1979, Biogenic amine metabolism in Tourette syndrome, Ann. Neurol. 6: 37–39.PubMedCrossRefGoogle Scholar
  13. Cassens, G., Roffman, M., Kuruc, A., Orsulak, P. J., and Schildkraut, J. J., 1980, Alterations in brain norepinephrine metabolism induced by environmental stimuli previously paired with inescapable shock, Science 209: 1138–1139.PubMedCrossRefGoogle Scholar
  14. Cedarbaum, J. M., and Aghajanian, G. K., 1976, Noradrenergic neurons of the locus coeruleus: Inhibition by epinephrine and activation by the alpha-antagonist piperoxane, Brain Res. 112: 413–419.PubMedCrossRefGoogle Scholar
  15. Chiodo, L. A., Caggiula, A. R., and Sailer, C. F., 1981, Estrogen potentiates the stereotypy induced by dopamine agonists in the rat, Life Sci. 28: 827–835.PubMedCrossRefGoogle Scholar
  16. Cohen, D. J., Shaywitz, B. A., Young, J. G., Carbonari, C. M., Nathanson, J. A. Lieberman, D., Bowers, M. B., Jr., and Maas, J. W., 1979a, Central biogenic amine metabolism in children with the syndorme of chronic multiple tics of Gilles de la Tourette syndrome: Norepinephrine, serotonin, and dopamine, J. Am. Acad. Child. Psychiatry 18: 320–341.PubMedCrossRefGoogle Scholar
  17. Cohen, D. J., Young, J. G., Nathanson, J. A., and Shaywitz, B. A., 1979b, Clonidine in Tourette’s syndrome, Lancet 2: 551–553.PubMedCrossRefGoogle Scholar
  18. Cohen, D. J., Detlor, J., Shaywitz, B. A., and Leckman, J. F., 1982, Interaction of biological and psychological factors in the natural history of Tourette syndrome: A paradigm for childhood neuropsychiatric disorders, in: Gilles de la Tourette Syndrome, Advances in Neurology, Vol. 35 ( A. J. Friedhoff and T. N. Chase, eds.), pp. 31–40, Raven Press, New York.Google Scholar
  19. Connell, P. H., 1958, Amphetamine Psychosis, Oxford University Press, London.Google Scholar
  20. Connell, Ph.H., Corbett, J. A. Horne, D. J., and Matthews, A. M., 1967, Drug treatment of adolescent tiqueurs: A double-blind trial of diazepam and haloperidol, Psychiatry 113: 375–381.CrossRefGoogle Scholar
  21. Corcoran, M. E., 1981, Catecholamines and kindling, in: Kindling, Vol. 2 ( J. A. Wada, ed.), pp. 87–104, Raven Press, New York.Google Scholar
  22. Coyle, J. T., and Campochiaro, P., 1976, Ontogenesis of dopaminergic-cholinergie interactions in rat striatum. A neurochemical study, J. Neurochem. 27: 673–678.PubMedCrossRefGoogle Scholar
  23. Creese, I., and Iversen, S. D, 1972, Amphetamine response in rat after dopamine neurone destruction, Nature (New Biol.) 238: 247–248.Google Scholar
  24. Curzon, G., Hutson, P. H., and Knott, P. J., 1979, Voltammetry in vivo: Effect of stressful manipulations and drugs on the caudate nucleus of the rat, Br. J. Pharmacol. 66: 127P - 128 P.PubMedGoogle Scholar
  25. Dawbarn, D., and Pycock, C. J., 1982, Lesions of the superior colliculus in the rat differentiate between nigrostriatal and mesolimbic dopamine systems, Brain Res. 135: 148.CrossRefGoogle Scholar
  26. Deakin, J. F., and Green, A. R., 1978, The effects of putative 5-hydroxytryptamine antagonists on the behavior produced by administration of tranylcypromine and L-tryptophan or tranylcypromine and L-dopa to rats, Br. J. Pharmacol. 64: 201–209.PubMedGoogle Scholar
  27. Deakin, J. F., Owen, F., Cross, A. J., and Dashwood, M. J., 1981, Studies on possible mechanisms of action of electroconvulsive therapy; Effects of repeated electrically induced seizures on rat brain receptors for monoamines and other neurotransmitters, Psychopharmacology 73:345-349PubMedCrossRefGoogle Scholar
  28. Delgado, J. M. R., and Armand, B. K., 1953, Increase in food intake induced by electrical stimulation of the lateral hypothalamus, Am. J. Physiol. 172: 162–168.PubMedGoogle Scholar
  29. Diamond, B. I., Reyes, M. G., and Borison, R., 1982, A new animal model for Tourette Syndrome, in: Gilles de la Tourette Syndrome, Advances in Neurology, Vol. 35 ( A. J. Friedhoff and T. N. Chase, eds.), pp. 221–226, Raven Press, New York.Google Scholar
  30. Eichler, A. J., and Antelman, S. M., 1979, Sensitization to amphetamine and stress may involve nucleus accumbens and medial frontal cortex, Brain Res. 176: 412–416.PubMedCrossRefGoogle Scholar
  31. Eldridge, R., Sweet, R., Lake, C. R., Ziegler, M., and Shapiro, A. K., 1977, Gilles de la Tourette’s syndrome: Clinical, genetic, psychologic, and biochemical aspects in 21 selected families, Neurology 27: 115–155.PubMedGoogle Scholar
  32. Ellison, R. M., 1964, Gilles de la Tourette’s syndrome, Med. J. Aust. 1: 153–155.PubMedGoogle Scholar
  33. Ernst, A. M., and Smelik, P. G., 1966, Site of action of dopamine and apomorphkne on compulsive gnawing behavior in rats, Experientia 22: 837–838.PubMedCrossRefGoogle Scholar
  34. Fog, R., and Pakkenberg, H., 1980, Theoretical and clinical aspects of the Tourette syndrome (chronic multiple tic). J. Neural Transm. 16 (Suppl.): 21l - 215.Google Scholar
  35. Friedhoff, A. J., 1982, Receptor maturation in pathogenesis and treatment of Tourette syndrome, in: Gilles de la Tourette Syndrome, Advances in Neurology, Vol. 35 ( A. J. Friedhoff and T. N. Chase, eds.), pp. 133–140, Raven Press, New York.Google Scholar
  36. Gianutsos, G., Drawbaugh, R. B., Hynes, M. D., and Lat, H., 1974, Behavioral evidence for dopaminergic supersensitivity after chronic haloperidol, Life Sci. 14: 887–899.PubMedCrossRefGoogle Scholar
  37. Gilles de la Tourette, G., 1885, Etude sur une affection nerveuse, caracterisee par de]’incoordi-nation motrice, acompagnee d’echolalie et de coprolalia, Arch. Neurol. (Paris) 9: 19–42Google Scholar
  38. Goddard, G. V., McIntyre, D. C., and Leech, C. K., 1969, A permanent change in brain function resulting from daily electrical stimulation, Exp. Neurol. 25: 295–330.PubMedCrossRefGoogle Scholar
  39. Golden, G. S., 1974, Gilles de la Tourette’s syndrome following methylphenidate administration, Dev. Med. Child Neurol. 16: 76–78.PubMedCrossRefGoogle Scholar
  40. Golden, G. S., 1977, The effect of central nervous system stimulants on Tourette syndrome, Ann. Neurol. 2: 69–70.PubMedCrossRefGoogle Scholar
  41. Gordon, J. H., 1980, Modulation of apomorphine-induced stereotypy by estrogen: Time course and dose response, Brain Res. Bull. 5: 679–682.PubMedCrossRefGoogle Scholar
  42. Guisado, E., Fernadez-Tome, P., Garzon, J., and Del Rio, J., 1980, Increased dopamine receptor binding in the striatum of rats after long-term isolation, Eur. J. Pharmacol. 65: 463–464.PubMedCrossRefGoogle Scholar
  43. Herman, J. P., Guillonneau, D., Dantzer, R., Scatton, B., Semerdjian-Rouquier, L., and Le Moal, M., 1982, Differential effects of inescapable footshocks and of stimuli previously paired with inescapable footshocks of dopamine turnover in cortical and limbic areas of the rat, Life Sci. 30: 2207–2214.PubMedCrossRefGoogle Scholar
  44. Hollister, A. S., Breese, G. R., and Cooper, B. R., 1974, Comparison of tyrosine and dopaminebeta-hydroxylase inhibition with the effects of various 6-hydroxydopamine treatments on d-amphetamine induced motor activity, Psychopharmacologia 36: 1–16.PubMedCrossRefGoogle Scholar
  45. Jagger, J., Prusoff, B. A., Cohen, D. J., Kidd, K. K., Carbonari, C. M., and John, K., 1982, The epidemiology of Tourette’s syndrome: A pilot study, Schizophrenia Bull. 8: 267–278.Google Scholar
  46. Jenkins, R. L., and Ashby, H. B., 1983, Tourette’s disorder in identical twins: Report of a case, Arch. Neurol. 40: 249–251.PubMedCrossRefGoogle Scholar
  47. Kellogg, C., and Lundborg, P., 1973, Inhibition of catecholamine synthesis during ontogenic development, Brain Res. 61: 321–329.PubMedCrossRefGoogle Scholar
  48. Kelly, P. H., Seviour, P. W., and Iversen, S. D., 1975, Amphetamine and apomorphine responses in the rat following 6-OHDA lesions of the nucleus accumbens septi and corpus striatum, Brain Res. 94: 507–522.PubMedCrossRefGoogle Scholar
  49. Kidd, K. K., and Pauls, D. L., 1982, Genetic hypotheses for Tourette syndrome, in: Gilles de la Tourette Syndrome, Advances in Neurology, Vol. 35 ( A. J. Friedhoff and T. N. Chase, eds.) pp. 243–249, Raven Press, New York.Google Scholar
  50. Kidd, K. K., Prusoff, B. A., and Cohen, D. J., 1980, Familial pattern of Gilles de la Tourette syndrome, Arch. Gen. Psychiatry. 37: 1336–1339.PubMedCrossRefGoogle Scholar
  51. Klawans, H. L., Falk, D. K., Nausieda, P. A., and Weiner, W. J., 1978, Gilles de la Tourette syndrome after long term chlorpromazine therapy, Neurology (Minneap.) 28: 1064–1066Google Scholar
  52. Klempel, K., 1974, Gilles de la Tourette’s symptoms induced by L-dopa, S. Afr. Med. J. 48:1379–1380.PubMedGoogle Scholar
  53. Knott, P. J., and Hutson, P. H., 1982, Stress-induced stereotypy in the rat: Neuropharmacological similarities to Tourette Syndrome, in Gilles de la Tourette Syndrome, Advances in Neurology, Vol. 35 ( A. J. Friedhoff and T. N. Chase, eds.), pp. 233–238, Raven Press, New York.Google Scholar
  54. Kobayashi, R. M., Palkovits, M., Kizev, J. S., Jacobowitz, D. M., and Kopin, I. J., 1976, Selective alterations of catecholamines and tyrosine hydroxylase activity in the hypothalamus following acute and chronic stress, in: Catecholamines and Stress ( E. Usdin, R. Kuetnansky, and I. J. Kopin, eds.), pp. 28–38, Pergamon Press, Oxford.Google Scholar
  55. Kokkinidis, L., Irwin, J., and Anisman, H., 1979, Shock induced locomotor excitation following acute and chronic amphetamine treatment, Neuropharmacology 18: 13.PubMedCrossRefGoogle Scholar
  56. Leckman, J. F., Cohen, D. J., Shaywitz, B. A., Caparulo, B. K., Heninger, G. R., and Bowers, M. B., Jr., 1980a, CSF monoamine metabolites in child and adult psychiatric patients: A developmental perspective, Arch. Gen. Psychiatry. 37: 677–681.PubMedCrossRefGoogle Scholar
  57. Leckman, J. F., Maas, J. W., Redmond, D. E., Jr., and Heninger, G. R., 1980b, Effects of oral clonidine on plasma 3-methoxy-4-hydroxyphenethyleneglycol (MHPG) in man: Preliminary report. Life Sci. 26: 2179–2185.PubMedCrossRefGoogle Scholar
  58. Leckman, J. F., Maas, J. W., and Heninger, G. R., 1981, Covariance of plasma free 3-methoxy4-hydroxyphenethyleneglycol and diastolic blood pressure, Eur. J. Pharmacol. 70: 111–120.PubMedCrossRefGoogle Scholar
  59. Leckman, J. F., Cohen, D. J., Detlor, J., Young, J. G., Harcherik, D., and Shaywitz, B. A., 1982, Clonidine in the treatment of Tourette syndrome: A review of data, in: Gilles de la Tourette Syndrome, Advances in Neurology, Vol. 35 ( A. J. Friedhoff and T. N. Chase, eds.), pp. 391–402, Raven Press, New York.Google Scholar
  60. Leckman, J. F., Detlor, J., and Cohen, D. J., 1983a, Gilles de la Tourette syndrome: Emerging areas of clinical research, in: Childhood Psychopathology and Development ( S. B. Guze, F. J. Earls, and J. E. Barrett, eds.), pp. 211–229, Raven Press, New York.Google Scholar
  61. Leckman, J. F., Detlor, J., Harcherik, D. F., Young, J. G., Anderson, G. M., Shaywitz, B. A., and Cohen, D. J., 1983b, Acute and chronic clonidine in Tourette’s syndrome: A preliminary report on clinical response and effect on plasma and urinary catecholamine metabolites, growth hormone, and blood pressure, J. Am. Acad. Child Psychiatry 22: 433–440.CrossRefGoogle Scholar
  62. Leckman, J. K., Detlor, J., Harcherik, D. F., Ort, S., Shaywitz, B. A., and Cohen, D. J., 1985, Short-and long-term treatment of Tourette’s syndrome with colnidine: A clinical perspective, Neurology 35: 343–351.PubMedGoogle Scholar
  63. Leith, N. J., and Kuczenski, R., 1982, Two dissociable components of behavior sensitization following repeated amphetamine administration, Psychopharmacology 76: 310–315.PubMedCrossRefGoogle Scholar
  64. Loizou, L. A., and Salt, P., 1970, Regional changes in monoamines of the rat brain during postnatal development, Brain Res. 20: 467–470.PubMedCrossRefGoogle Scholar
  65. Lowe, T. L., Cohen, D. J., Detlor, J., Kremenitzer, M. W., and Shaywitz, B. A., 1982, Stimulant medications precipitate Tourette’s syndrome, JAMA 247: 2739–1731.Google Scholar
  66. Maas, J. W., Hattox, S. E., Landis, D. H.,. and Roth, R. H., 1977, A direct method for studying 3-methoxy-4-hydroxyphenethyleneglycol (MHPG) production by brain in awake animals, Eur. J. Pharmacol. 46: 221–118.PubMedCrossRefGoogle Scholar
  67. MacLennan, H. J., and Maier, S. F., 1983, Coping and the stress-induced potentiation of stimulant stereotypy in the rat, Science 219: 1091–1092.PubMedCrossRefGoogle Scholar
  68. Messiha, F. S., Knopp, W., Vanecko, Ss., O’Brien, V., and Corson, S. A., 1971, Haloperidol therapy in Tourette’s syndrome: Neurophysiological, biomedical and behavioral correlates, Life Sci. 10: 449–457.CrossRefGoogle Scholar
  69. Moldofsky, H., Tullis, C., and Lamon, R., 1974, Multiple tic syndrome (Gilles de la Tourette’s syndrome): Clinical, biological, and psychosocial variables and their influence with haloperidol, J. Nerv. Ment. Dis. 159: 282–292.PubMedCrossRefGoogle Scholar
  70. Morrell, F., 1973, Goddard’s kindling phenomenon: A new model of “mirror focus,” in: Chemical Modulation of Brain Function (H. C. Sabelli, ed.), pp. 207–223, Raven Press, New York.Google Scholar
  71. Nee, L. E., Caine, E. D., Polinsky, R. J., Eldridge, R., and Ebert, M. H., 1980, Gilles de la Tourette syndrome: Clinical and family study of 50 cases, Ann. Neurol. 7: 41–49.PubMedCrossRefGoogle Scholar
  72. Pauls, D. L. Cohen, D. J., Heimbuch, R., Detlor, J., and Kidd, K. K., 1981, Familial pattern and transmission of Gilles de la Tourette syndrome and multiple tics, Arch. Gen. Psychiatry 38: 1091–1093.PubMedCrossRefGoogle Scholar
  73. Post, R. M., and Kopanda, R. T., 1976, Cocaine, kindling, and psychosis, Am. J. Psychiatry. 133: 627–634.PubMedGoogle Scholar
  74. Price, R. A., Kidd, K. K., Cohen, D. J., Pauls, D. L., and Leckman, J. F.. 1985, A twin study of Tourette syndrome, Arch. Gen Psychiatry 42: 815–820.PubMedCrossRefGoogle Scholar
  75. Racine, R. J., Burnham, W. M., Gartner, J. G., and Levitan, D., 1973, Rates of motor seizure development in rats subjected to electrical brain stimulation: Strain and interstimulation interval effects, Electroencephalo. Clin. Neurophysiol. 35: 553–556.CrossRefGoogle Scholar
  76. Randrup, A., and Munkvard, L., 1974, Pharmacology and physiology of stereotyped behavior, J. Psychiatr. Res. 2: 1.CrossRefGoogle Scholar
  77. Robbins, T. W., and Sahakian, B. J., 1981, Behavioral and neurochemical determinants of drug-induced stereotypy, in: Metabolic Disorders of the Nervous System, pp. 244–491, Pitman Books, Ltd., London.Google Scholar
  78. Ross, M. S., and Moldofsky, H., 1977, Comparison of pimozide with haloperidol in Gilles de la Tourette syndrome, Lancet 1: 103.CrossRefGoogle Scholar
  79. Sahakian, B. J., Robbins, T. W., Morgan, M. J., and Iversen, S. J., 1975, The effects of psychomotor stimulants on stereotypy and locomotor activity in socially-deprived and control rats, Brain Res. 84: 195–205.PubMedCrossRefGoogle Scholar
  80. Schmitt, H., Schmitt, H., and Fenard, S., 1971, Evidence for an -sympathomimetic component in the effects of catapresan on vasomotor centres: Antagonism by piperoxane, Eur. J. Pharmacol. 14: 98–100.PubMedCrossRefGoogle Scholar
  81. Segal, D. S., 1975, Behavioral and neurochemical correlates of repeated d-amphetamine administration, in: Neurobiological Mechanisms of Adaptation anad Behavior ( A. J. Mandell, ed.), pp. 247–262, Raven Press, New York.Google Scholar
  82. Shalaby, I. A., and Spear, L. P., 1980, Psychopharmacological effects of low and high doses of apomorphine during ontogeny, Eur. J. Pharmacol. 67: 451–459.PubMedCrossRefGoogle Scholar
  83. Shapiro, A. K., and Shapiro, E., 1981, The treatment and etiology of tics and Tourette syndrome, Comp. Psychiatry. 22: 193–205.CrossRefGoogle Scholar
  84. Shapiro, A. K., Shapiro, E., and Wayne, H., 1973, Treatment of Tourette’s syndrome with haloperidol, review of 34 cases, Arch. Gen Psychiatry. 28: 92–97.PubMedCrossRefGoogle Scholar
  85. Shapiro, A. K., Shapiro, E. S., Bruun, R. D., and Sweet, R. D., 1978, Gilles de la Tourette Syndrome, Raven Press, New York.Google Scholar
  86. Sharma, J. N., Sandrew, B. B., and Wang, S. C., 1978, CNS sites of clonidine induced hypotension: A microiontophoric study of bulbar cardiovascular neurons, Brain Res. 151: 127–133.PubMedCrossRefGoogle Scholar
  87. Stahl, S. M., 1980, Tardive Tourette syndrome in autistic patient after long-term neuroleptic administration, Am. J. Psychiatry 137: 1267–1969.PubMedGoogle Scholar
  88. Szechtman, H., Ornstein, K., Teitelbaum, P., and Golani, I., 1982, Snout contact fixation, climbing and gnawing during apomorphine stereotypy in rats from two substrains, Eur. J. Pharmacol. 80: 385–392.PubMedCrossRefGoogle Scholar
  89. Wasserman, E. R., Eldridge, R., Abuzzahab, S., and Nee, L., 1978, Gilles de la Tourette syndrome: Clinical and genetic studies in a midwestern city, Neurology (Minneap.) 28: 304–307.Google Scholar
  90. Watanabe, H., Nakano, S., and Ogawa, N., 1982, Age difference in apomorphine-induced stereotypy in rats: Relationship to plasma and brain concentrations, Psychopharmacology 76: 5761.CrossRefGoogle Scholar
  91. Wilson, R. S., Garron, D. C., and Klawans, H. L., 1978, Significance of genetic factors in Gilles de la Tourette syndrome: A review, Behay. Genet. 8: 503–510.CrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1986

Authors and Affiliations

  • James F. Leckman
    • 1
  • Donald J. Cohen
    • 2
  • R. Arlen Price
    • 3
  • Mark A. Riddle
    • 1
  • Ruud B. Minderaa
    • 4
  • George M. Anderson
    • 5
  • David L. Pauls
    • 6
  1. 1.Child Study Center, Children’s Clinical Research Center, and Departments of Psychiatry and PediatricsYale UniversityNew HavenUSA
  2. 2.Child Study Center, Children’s Clinical Research Center, and Departments of Psychiatry, Pediatrics, and PsychologyYale UniversityNew HavenUSA
  3. 3.Department of PsychiatryUniversity of PennsylvaniaPhiladelphiaUSA
  4. 4.Eramus Universiteit RotterdamRotterdamThe Netherlands
  5. 5.Child Study Center and Department of Laboratory MedicineYale UniversityNew HavenUSA
  6. 6.Child Study Center and Department of Human GeneticsYale UniversityNew HavenUSA

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